Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041Description Your treatment is called infliximab (in-FLIX-i-mab) or Remicade® (REM-eh-kaid). Infliximab is used to treat rheumatoid arthritis (RA) and has also been used to treat other diseases. Infliximab is a type of medicine called a tumor necrosis factor (TNF) blocker. TNF is a protein made by your immune system and is part of the normal inflammatory process. Those with RA have too much TNF. Infliximab works by lowering the amount of TNF in your body. This helps decrease the inflammation, pain and other symptoms of RA.
What Do I Need to Know Before Starting Treatment?
- Be sure to tell your healthcare provider about any prescription or over-the-counter products you are taking, including dietary supplements, vitamins, herbal medicines and homeopathic remedies.
- Use an effective birth control method while you are being treated. It is not known if infliximab causes harm to a fetus, so be sure to tell your healthcare provider right away if you or your partner becomes pregnant.
- Avoid breastfeeding during treatment. It is not known if infliximab passes into breast milk.
- You should have any vaccines you need before beginning infliximab. Do not get any live vaccines while you are being treated with infliximab. Do not get any other types of immunizations or vaccinations while you are being treated without the approval of your healthcare provider.
What Do I Need to Know Before Starting Infliximab?
- nfliximab can increase your risk of getting an infection or make any infection that you have worse. Upper respiratory, sinus and bladder infections are common during treatment with infliximab. Tell your healthcare provider immediately if you have any signs of infection, such as fever, cough, flu-like symptoms, feeling very tired, painful or frequent urination or if you have warm, red or painful skin. Tell your healthcare provider if you have an infection that does not go away or a history of infections that keep coming back. Also tell your healthcare provider if you have an illness that puts you at high risk for infections, such as cancer, HIV or diabetes that is not well controlled. If you have had hepatitis B, infliximab can increase the risk that the hepatitis B will become active again. In rare cases, reactivation of hepatitis B can cause liver failure.
- Tell your healthcare provider if you have had tuberculosis (TB), a positive TB skin test or if you have recently been in contact with someone who has TB. Infliximab can cause TB that has already been treated to become active again. Your healthcare provider will give you a TB skin test before starting treatment and will watch you closely during treatment. Tell your healthcare provider right away if you have symptoms of TB, such as a cough that does not go away, coughing up blood, chest pain, pain when breathing or coughing, unexplained weight loss, fever, chills, night sweats or fatigue.
- Tell your healthcare provider if you have recently visited or ever lived in the Ohio or Mississippi River Valleys or the southwestern part of the U.S. If so, you may be at higher risk for certain types of fungal infections. Infliximab can put you at even higher risk for these infections.
- The infections caused by infliximab can be severe and life-threatening.
- In rare cases, infliximab may decrease your body’s ability to make enough blood cells that help fight infection or help stop bleeding. Tell your healthcare provider right away if you have nose bleeds, bleeding gums when you brush your teeth, a fever that does not go away, easy bruising or if you look very pale. This side effect can be severe and life-threatening.
- Tell your healthcare provider if you have any disease of the central nervous system (CNS) such as seizures, multiple sclerosis or inflammation of the nerves in the eyes. In rare cases, infliximab can cause diseases of the CNS or make them worse. Tell your healthcare provider if you have vision problems, changes in your mental health, dizziness, seizures or weakness, numbness or tingling in your arms or legs.
- Infliximab can cause problems with your heart including heart attack and irregular heart rhythms. In rare cases, it can cause heart failure or make heart failure worse. Tell your healthcare provider if you are being treated for a heart problem. Call your healthcare provider immediately if you have chest pain, shortness of breath, a cough or swelling in your ankles or feet.
- In rare cases, infliximab can cause an allergic reaction. This reaction usually occurs within two hours of the infusion. Tell your healthcare provider right away if you have shortness of breath, hives, trouble breathing or swallowing, muscle and joint pain, or swelling of your tongue, eyelids or face.
- Tell your healthcare provider if you have liver disease or liver failure. Your risk of side effects from infliximab may be higher.
- In rare cases, infliximab can cause immune reactions such as a lupus-like syndrome. Symptoms include joint pain and a rash on the face and arms that gets worse in the sun. Tell your healthcare provider if you have these symptoms.
- Infliximab can increase the risk of developing certain cancers, especially leukemia and lymphoma. The risk of certain cancers, such as lung cancer, may be higher if you receive infliximab and have chronic lung disease. Tell your healthcare provider if you have a chronic lung condition called chronic obstructive pulmonary disease (COPD).
- Anakinra (Kineret®)
Who Should Not Take This TreatmentYou should not take this treatment if you:
- Are allergic to infliximab or any of its components.
- Have heart failure.
- Have an active infection.
How Is the Treatment Given?
- Infliximab is given by injection into a vein. Your healthcare provider will determine your dose and how often you use infliximab.
- You may be given medicine to help prevent or decrease the side effects of infliximab.
- If you are given any medicine to take at home, do not share it with others. Sharing medication with anyone else could be harmful.
When Should I Call My Healthcare Provider?Call your healthcare provider right away if you have any of the following symptoms:
- Shaking chills or fever of 100.5 degrees F or higher
- Irregular or rapid heartbeat, chest pain, chest tightness, shortness of breath, difficulty breathing or swallowing, or swelling of your tongue, eyelids face, ankles or feet
- Dizziness, seizures or feeling lightheaded
- A dry cough that does not go away
- Painful, difficult or frequent urination
What Are the Possible Side Effects?All drugs can cause side effects, but every person reacts differently to each drug. The following chart lists the possible side effects that can occur with your treatment. The side effects are grouped by how often the side effect occurs: Less Common (occurred in 5 to 25 percent of patients) or Rare (occurred in less than 5 percent of patients).
Less Common Side Effects
- Nausea, diarrhea or indigestion
- Abdominal, back or joint pain
- Rash or itching
- High blood pressure
- Fainting or low blood pressure
- Constipation or blockage in the bowel